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Elevated liver enzymes?

Tricia, Daw, or anyone who might have info in this area, I have been on Nexium for a little over 8 months. In that time, my AST went from 18 to 31 and my ALT went from 19 to 33. I am still within the 'normal' range, though just barely. However, I am concerned about the rise. I can only attribute it to the Nexium. My doctor made no mention of this when he reported my blood work, only said my numbers were within normal range. However, when I looked back at my past tests I noticed this steep incline. Previous to Nexium, I had been on Ranitidine but had very severe side effects so went to the Nexium. Do you think this is reason to be concerned?

Hi missj,
Doctors usually don't stop or change the PPI unless the enzyme level is 2 to 3 times the upper normal range. If your lab's upper limit is 40 then you are talking about 80 -120. This I found to be true with statin drugs too. I had an elevated ALT while I was taking large doses of prescription Pepcid. It ranged between 35 and 49 out of a lab range of 0-40. My billirubin was raised too. None of my doctor's seemed to care and I had to ask my GI for blood tests to be done to rule out possible liver problems (like hepatitis). When everything came back negative, I was sure it was the Pepcid but couldn't prove it until I went off of it and my ALT went back to normal very quickly.

If you are really concerned, you can try changing the medication or taking less if that is possible. I lived with the slightly raised ALT for years and nothing much happened....but I can understand your worrying.

Hi Daw. You wrote that you stayed on the drug which made your enzymes rise for a couple of years. My question is did the numbers continuously go up or did they peak and then level off while you stayed on the drug? Thank you for your help!

missj,
I dug out all my old lab reports. Before I started taking Pepcid my ALT was in the 20's. The first lab report after I had been taking Pepcid 80mg for one year showed the ALT as 56 on a 0-40 lab range. Then 10 months later the ALT was 49 while I was taking Pepcid 60mg. Then another 10 months it was 41 while I played with the Pepcid anywhere from 40-60mg but mostly 60mg. (note: I was also taking Nexium 40mg 6 months after starting Pepcid.) Then due to terrible LPR symptoms I was switched to Nexium 40mg twice a day and the Pepcid was stopped. Two weeks later my lab work showed ALT was 35. My latest lab work shows ALT back in the 20s again.